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Panic Disorder Treatment
Why Seeking Treatment Is Critical
Repeated episodes of fear, commonly called panic attacks, that are
typical of panic disorder can be devastating. The panic attacks, or
avoidance of them, can completely take control of your life.
- Without treatment, you may continue to have panic attacks for
years. The disorder can seriously interfere with your relationships with
family, friends, and co-workers.
- Without treatment, your life may become severely restricted. For
example, you may start to avoid certain situations where you fear you
will experience a panic attack, even normal, everyday activities, such
as grocery shopping or driving. In extreme cases, people with untreated
panic disorder grow afraid to leave the house, a condition known as
agoraphobia.
- Without treatment, you may find it difficult to be productive at
work. Your symptoms may keep you from getting to your job or staying
there once you arrive. You may turn down promotions or job assignments
that you believe will make you more likely to have panic attacks. Some
people with panic disorder even quit their jobs. Many can keep working
but otherwise rarely leave home.
- Without treatment, you may become severely depressed. You may try
unsuccessfully to numb the symptoms of panic disorder or depression with
alcohol or other drugs. You may even begin to have thoughts about
suicide.
- You do not have to live this way. You need to know that panic
disorder is treatable . In fact, proper treatment reduces or
completely prevents panic attacks in 70 to 90 percent of people.
Many people feel substantial relief in just weeks or months.
Unfortunately, some people are reluctant to pursue treatment. Perhaps
they think their condition is not serious. Perhaps they feel
embarrassed. They may blame themselves or have trouble asking for help.
Perhaps they dislike the idea of medication or therapy. Or, maybe they
have sought help but are frustrated because their condition was not
diagnosed or treated effectively.
Do not let these or any other reasons stop you from getting proper
treatment. If you have panic disorder, you should get whatever help is
necessary to overcome it, just as you would for any serious medical
illness.
Do not be discouraged if some people say, "It's nothing to worry about,"
"It's just stress," "It's all in your head," or "Snap out of it." While
they often mean well, the fact is that most people who do not have panic
disorder do not understand that it is REAL and, therefore, tend to doubt
its seriousness.
Most importantly, do not try to numb the effects of panic attacks with
alcohol or other drugs. This will only make the problem worse.
Getting a Diagnosis
Since panic disorder can mimic a variety of medical conditions, such as
heart problems and digestive complaints, the first thing you should do
is have a full medical evaluation.
Although it is important for you and your doctor to concentrate on your
physical symptoms, you should not overlook other aspects of your attacks.
You may want to re-read the questions at the beginning of this pamphlet
and tell your doctor anything you notice about how your attacks make you
feel and when they usually occur.
Information on both the physical and emotional aspects of the attacks can
be very useful to the doctor in making a diagnosis. For example, the
doctor will want to know if your attacks, or fear of having attacks, keep
you from carrying out any of your normal activities.
Many people with panic disorder also suffer from depression--feelings of
intense sadness, even hopelessness. Depression is accompanied by an
impaired ability to think, concentrate, and enjoy the normal pleasures
of life. Be sure to make your doctor aware of these symptoms as well.
If you have been drinking or using drugs to try to control your symptoms,
let your doctor know about that too.
Once you have been properly diagnosed, your doctor--perhaps in
consultation with a mental health specialist--can help you determine
which treatment is best for you.
Effective Treatments for Panic Disorder
Treatment for panic disorder can consist of taking a medication to adjust
the chemicals in your body--just as you might take medicine to correct
a thyroid imbalance.
Or treatment might involve working with a psychotherapist to gain more
control over your anxieties--just as some people work with specialists
to learn techniques to control migraine headaches or lower their blood
pressure.
Research shows that both kinds of treatment can be very effective. For
many patients, the combination of medication and psychotherapy appears
to be more effective than either treatment alone. Early treatment can
help keep panic disorder from progressing.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) teaches you to anticipate and prepare
yourself for the situations and bodily sensations that may trigger panic
attacks. CBT usually includes the following elements:
- A therapist helps you identify the thinking patterns that lead you
to misinterpret sensations and assume "the worst" is happening. These
patterns of thinking are deeply ingrained, and it will take practice to
notice them and then to change them.
- A therapist can teach you breathing exercises that calm you and
that can prevent the overbreathing, or hyperventilation, that often
occurs during a panic attack.
- A therapist can help you gradually become less sensitive to the
frightening bodily sensations and feelings of terror. This is done by
helping you, step-by-step, to safely test yourself in the places and
situations you've been avoiding.
CBT generally requires at least 8 to 12 weeks. Some people may need a
longer time in treatment to learn the skills and put them into practice.
Most panic disorder patients are successful in controlling or preventing
their panic attacks after completing treatment with CBT.
CBT requires a motivated patient and a specially trained therapist. Make
sure any therapist you work with has proper training and experience in
this method of panic disorder treatment. Indeed, in some parts of the
country, you may find limited access to professionals trained and
experienced in CBT.
Medication
Several types of medication that alter the ways chemicals interact in the
brain can reduce or prevent panic attacks and decrease anxiety. Two
major categories of medication that have been shown to be safe and
effective in the treatment of panic disorder are antidepressants and
benzodiazepines.
Each medication works differently. Some work quickly and others more
gradually. All of them have to be taken on a regular basis. Usually,
treatment with medication lasts at least 6 months to a year. But within
8 weeks, you and your doctor should be able to assess whether it's
effectively blocking the panic attacks. More details on medications can
be found in the brochure "Understanding Panic Disorder." To get a copy,
see the back of this pamphlet.
Clinical experience suggests that for many patients with panic disorder,
a combination of CBT and medication may be the best treatment. The
National Institute of Mental Health (NIMH) is conducting a large study
to confirm this and to help determine the kinds of patients most likely
to need combined therapy.
How to Choose the Right Treatment for You
Various types of health professionals may have the training and
experience needed to treat panic disorder. Sometimes panic disorder
patients are treated by two health care professionals - one who prescribes
and monitors medication and another who provides CBT.
Each professional will use the treatments with which he or she is most
familiar and successful. It is vital to choose a professional who is
trained and experienced in the treatment methods described earlier; it
is equally important to choose someone with whom you feel comfortable.
Many people begin looking for treatment by visiting their family doctor
or a local clinic or health maintenance organization. Other places to
seek help include your local health department or community mental health
clinic. If there is a university near you, you may wish to ask about
participating in a panic disorder study. Many universities have ongoing
treatment research programs in their psychology or psychiatry departments
that may provide care at less expense.
To help you locate mental health professionals in your area, NIMH has
available a Referral List, which gives the names and telephone numbers
of organizations that can provide you with a referral. If you did not
receive a copy of the list with this brochure, you can get one by calling
1-800-64-PANIC.
When seeking a health care professional to treat your panic disorder, you
may want to ask the following questions:
- How many patients with panic disorder have you treated?
- Do you have any special training in panic disorder treatment?
- What is your basic approach to treatment--cognitive-behavioral
therapy, medication, or both? If you provide only one type of
treatment, how do I get the other if I need it?
- How long is a typical course of treatment?
- How frequent are treatment sessions? How long does each session
last?
- What are your fees?
- Can you help me determine whether my health insurance will cover
this?
How To Make Your Treatment Successful
From the beginning, it is important to be a full participant in your
treatment. Be active and assertive. Ask questions. Maintain open
communication with your treatment professional and let him or her know
your concerns.
Every patient responds differently, but it is important to know that none
of the treatments for panic disorder works instantly. So, you must stick
with a particular treatment for at least 8 weeks to see if it works. If
you do not see significant improvement within that time, you and your
treatment professional can adjust your treatment plan. It may take a bit
of trial and error before you find what works best for you. Be patient
and be sure to communicate with your treatment professional. Of course,
if at any time you feel uncomfortable with the professional you have
chosen or don't think your treatment is going well, you should feel free
to consider seeking a second opinion or even changing providers.
If your treatment involves medication, talk with your doctor about how
often and in what manner your dosage will be monitored. No matter what
medication you are taking, your doctor is likely to start you on a low
dose and gradually increase it to the full dose. You should know that
every medication has side effects, but they usually become tolerated or
diminish with time. If side effects become a problem, the doctor may
advise you to stop taking the medication and to wait a week or so before
trying another medication. When your treatment is near an end, your
doctor will taper the dosage gradually.
Support Groups And Self-Help Tools
Patient-run support groups can be a rich source of information for people
with panic disorder. These groups typically involve 5 to 10 people who
meet weekly to talk about their experiences, encourage each other, and
share tips on coping strategies and local treatment resources.
Sometimes, family members are invited to attend.
The NIMH Referral List can help you find a support group in your area.
If there are no groups near you, you may want to form your own. Some of
the sources listed can aid you in doing this. NIMH also has a Resource
List that provides some self-help information about panic disorder,
including books, articles, and videotapes.
Another way to get help is to enlist the support of friends and family
members. You may want to share this booklet and other materials with
them so they can better understand panic disorder and its treatment.
Take the Next Step Today
Panic disorder is far too serious--and far too treatable--to delay
getting help. Recognizing the situation is the first step to recovery.
Now take the next step. If you think you may have panic disorder, act
now. See your health professional for a diagnosis and then follow the
suggestions in this booklet for making your treatment successful.
Educate yourself about your condition. The more you know about panic
attacks and panic disorder, the better you will understand your role in
treatment.
Remember, Panic Disorder Is Very Treatable. You Can Get Better.
Source:
U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health
National Institute of Mental Health
NIH Publication No. 94-3641
Printed 1994
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I have recovered from severe agoraphobia, on my own, no meds. I had been housebound for almost ten years. I am very proud of that. I continue with periods of hypomania and periods of depression related to Bi-polar d/o II however, and have GAD. I have some residual phobias but I generally do ok. I went to college and became a psychiatric Social Worker because I felt that if God could pull me out of the hell of full blown agoraphobia, then I must give back somehow. I have two kids now and a wonderful husband. Life is good, not always easy but I will never forget how far I have come. :) I look forward to meeting you all ! (Sat Jul 28 15:18 2007) Provides resource on Living Aids for people with disabilities
by offering competitively priced quality assisted living technology. (Thu Jun 21 23:46 2007) I have been told by a doctor who I talked with in Bergen Feb. 22, to read Aron T. Beck, and start cognitive restructurin of my memories. A pscyhciatric nurse told me no to stress when I felt a kind of claustrophobia. So when I read in the above article that some people try to convince the anxiety patient not to worry,etc. it is something I have experienced. This is sad, because it reveals a lack of professional understanding. I would like to get email from other persons who have been lucky enough to recover from panic anxiety and depression thanks to therapy. My email is kjeka@cadillaceldorado.net I live in South western Norway.I live from a disability pension, so I can afford to pay treatment at Modum Bad which costs about 4000 NOK every week. (Thu Nov 2 7:48 2006) hello. my name is kelly and im 18 years old. i was diagnosed with all different types of anxioty and panic disorders when i was 5. I recently had my first child and during pregnancy i had some anxioty,i thought ill be ok,yet the worst was still to come. When my daughter was 3 months old,my cat died. Now this seems rediculous but because of the death of my cat, it put me into anxioty overload. I got so bad i couldnt leave my house, eat( i lost alot of weight) and could hardly sit still to change my daughters diapers. The most important thing to know is youll be ok, and it wont last forever. What saved me was my psychiotrist and starting meds. If you suffer with anxioty and really need to speak to someone who has previously help it,my e-mail is naughtilicious16@yahoo.com, i check my e-mail all through the night. Because of my experiences, i think i can really help. (Sun Aug 27 1:57 2006) I have had panic dosorder for approx. 15 years. I take paxil daily and have klonopin for the times of actual panic attacks. I am OK with the physical responses of panic, but the mental change and sense of "unreality" I can almost not take anymore. Most treatments seem to focus on the physiological symptoms- not the mental ones. When my mind changes and slips into that "zone", breathing exercises just don't cut it. Does anyone understand, and have you found help for this??? (Wed Apr 5 17:25 2006) I went to the doctor almost 2 weeks ago and was given wellbutron for panic attacks and social anxioty disorder (i have had these problems since elementry school) i took paxil in 2002 and it worked great then i got off of it due to losing my insurance.well i got on wellbutron 150mg and it made me have migrain headaches and i was in lala land.so after 4 days of that i got back on paxil cr 12.5 mg.i started them tues and its now friday.wed morning i woke up and i was sweating so bad my sheets were soaked,i couldnt focus,dizzy,the doctor said to stay on them.thur i woke up same thing but not as bad but now i have an upset stomach and vomiting.today i am still dizzy with an upset stomach just not throwing up.how long will these side affects last? does anybody know? im ready to feel better............ (Fri Mar 10 19:09 2006) Hello all...I'm new to this forum..I have been having anxiety attacks for most of my life..Some meds help and some don't..I know anxiety has a multitude of symptoms that only rivals the number of stars in the sky. I have visited the emergency room coutless of times to rule out a heart attack..I once even had a heart cath..I think now I'm having blood pressure problems because of anxiety and the extra adrenalin that comes with it...I was just wondering if anybody else out ther is having blood pressure problems because of their anxiety..and if they do what meds are they on or what can I do to keep it down... (Sun Jul 17 14:07 2005) I am also interested in findign a therapist in Surrey area in England. My GP doesnt know anyone and he can only recommend me to a psichiatrist but there is a waiting list of 6 months at the moment. (Tue Oct 12 8:10 2004) I am interested in finding out about specialist in the area of CBT in England Buckinghamshire area/ Could you help?
Regards
Mrs Coupez |
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